Preparing for a test – DOBUTAMINE STRESS ECHOCARDIOGRAPHY

DOBUTAMINE STRESS TEST (DOBUTAMINE STRESS ECHO, STRESS TEST)  

ABOUT THE TEST:

A dobutamine stress test (stress echocardiography using dobutamine) is a non-invasive test (one that does not damage the body’s tissues) that involves monitoring the heart’s function using an echocardiography machine as the workload on the heart changes. During the test, dobutamine is given intravenously. This medicine speeds up the heart rate by increasing the volume of blood that the heart pumps into the blood vessels in one minute. Stress echocardiography combines two-dimensional echocardiography (a heart ultrasound scan) with an exercise electrocardiogram (exercise ECG stress test), which is why it is often presented as an alternative to an exercise stress test.

WHAT THE TEST INVOLVES:

A dobutamine stress echo involves monitoring the heart’s function using echocardiography. Before the test, an intravenous cannula is inserted. During the test, the patient receives dobutamine intravenously, a medicine that increases the strength of the heart muscle’s contractions. Dobutamine produces a state in the body similar to that following physical exertion. The medicine is administered gradually, starting at a dose of 10 µg/kg/min, which is increased every 3 minutes by 10 µg/kg/min until a maximum dose of 40-50µg/kg/min is reached. This allows successive echocardiographic images of the heart to be recorded as the workload on the heart changes. The test is performed in a suitably equipped consulting room at ETER-MED branch no. 1 in Gdańsk, at ul. Jaskółcza 7/15 (ground floor), under the constant supervision of the cardiologist performing the test. The test takes approximately half an hour.

PURPOSE OF THE TEST:

The purpose of a dobutamine stress test is to provoke a controlled shortage of oxygen in the heart muscle. It helps detect and assess the extent of heart muscle damage that may indicate coronary artery disease. The test can establish the presence and extent of myocardial ischaemia (an inadequate blood supply to the heart muscle), which occurs after dobutamine is given to people with the condition. In patients who have had a heart attack, stress echocardiography is highly valuable for assessing the viability of a particular area of heart muscle and predicting recovery of the left ventricle’s ability to contract in patients treated with primary angioplasty. An echocardiographic stress test also helps establish whether a patient with suspected or diagnosed heart disease should undergo coronary angiography or a procedure on the heart. It may also complement the results of an exercise ECG stress test.

WHEN THE TEST IS RECOMMENDED:

• Suspected coronary artery disease in people who are unable to exercise
• An abnormal resting ECG that prevents assessment of ischaemia
• A negative or positive exercise ECG stress test result that is inconsistent with the clinical picture
• Assessment before major non-cardiac surgery to determine the risk of cardiovascular complications
• Assessment of the functional significance of borderline abnormalities seen on coronary angiography.

CONTRAINDICATIONS TO THE TEST:

• Hypersensitivity to the medicine
• Conditions involving narrowing of the outflow tract from the heart’s left ventricle.
• Atrial fibrillation
• The acute phase of a heart attack
• Septic and cardiogenic shock with blood pressure below 80 mm Hg.

PREPARING FOR THE TEST:

Before the test, the patient should consult a doctor to discuss the details of the procedure. It is important to remember that beta-blockers reduce the effectiveness of dobutamine, so stopping these medicines on the day of the test is recommended. The patient’s medical history, including their treatment to date, is also important information for the cardiologist performing the dobutamine stress echo.

WAITING FOR THE RESULT:

The patient receives the result on the day of the dobutamine stress test. The result report is issued in Polish. The cardiologist performing the test assesses and interprets it on site and discusses it with the patient.

WHERE AND HOW CAN YOU HAVE THE TEST?

Stress echocardiography using dobutamine is performed in Gdańsk at ETER-MED branch no. 1, at ul. Jaskółcza 7/15